US: PrEP Treatment Works Well for At-risk Teenage Boys

A drug combination therapy has proven efficient as a pre-exposure prophylaxis (PrEP) for HIV in high-risk teenage boys.

Truvada, the pill combination of drugs tenofovir and emtricitabine (TDF/FTC) is currently approved as a daily at-risk adult PrEP. Its efficacy extends at least to males between 15 and 17 years old, study author Bill Kapogiannis, MD, said.

Kapogiannis, of the National Institute of Child Health and Human Development (NICHD) in the National Institutes of Health (NIH), noted that several studies exist showing Truvada’s efficacy in preventing HIV in high-risk adults, but none for an equally susceptible and younger demographic.

Current national data shows a continued increase of HIV rates among young Hispanic and black men who have sex with men, Kapogiannis told MD Magazine, providing the justification for the study.

“The epidemic has been focused among young minority men who have sex with men, and it looks like the diagnoses aren’t decreasing,” Kapogiannis said.

In 2015, youths accounted for 8% of the total AIDS diagnoses in the US that year, according to the Center for Disease Control and Prevention. Of that demographic, 81% (7,109) were gay or bisexual men, and 79% (5,560) were of black or Hispanic/Latino descent.

The 72 adolescent males featured in the NICHD study were at risk for infection, as defined by having unprotected sex with a male partner who either had HIV or whose HIV status was unknown, having at least 3 male sex partners, or having a different sexually transmitted infection.

The 48-week trial of oral Truvada proved safe and effective for the subjects. As patients were periodically tested for HIV, the lone 3 to be diagnosed also had no detectable levels of the PrEP treatment in their blood. It was indicative that the patients had either missed doses, or hadn’t taken the treatment at all.

In fact, lapses of treatment were notable in the patient group. The patient rate of reaching the level of Truvada sufficient to prevent HIV infection decreased over time, from 54% in week 4, 49% in week 12, 28% in week 24, and 22% in week 48.

Researchers were given commonly-reported reasons for treatment lapse, such as patients being away from home, being too busy, or just simply forgetting. The next step for researchers should be in establishing intervention methods that ensure a greater rate of treatment adherence, Kapogiannis said. Read more via MD